Radiologic Findings in Intimate Partner Violence

Abstract

To assess the radiologic findings associated with intimate partner violence (IPV). Materials and Methods:Electronic medical records of 185 patients referred to the IPV support program from the emergency department (ED) between January 2015 and October 2016 were retrospectively reviewed and compared with an age-and sex-matched control group of 555 subjects (1:3 ratio of IPV victims to control subjects) who presented to the ED. Reports of all imaging studies performed within 5 years prior to the index ED visit were reviewed. Results:The majority of patients who experienced IPV (mean age, 34.2 years 6 12.2 [standard deviation]) were female (178 of 185 [96.2%]) and were largely African American (69 of 185 [37.3%]). Demographic and clinical variables independently associated with IPV were race (odds ratio [OR] range, 3.2-5.9; 95% confidence interval [CI]: 1.8, 12.7), psychiatric comorbidities (OR, 5.4; 95% CI: 3.4, 8.8), and homelessness (OR, 13.0; 95% CI: 5.4, 31.2). IPV victims underwent more imaging studies in the preceding 5 years (median, four studies) than did control subjects (median, one study). Obstetric-gynecologic findings (OR, 4.4; 95% CI: 2.1, 9.6) and acute fractures (OR, 2.4, 95% CI: 1.1, 5.3) seen on images were independently associated with IPV. The addition of imaging findings to demographic and clinical variables increased the area under the receiver operating characteristic curve (AUC) of the multivariate model to detect IPV (0.87 vs 0.86, P , .01), and the cross-validated multivariate model had an AUC of 0.85. Acute fractures involved the face or skull (range, P , .01 to P = .05), and chronic fractures affected the extremities and nasal bone (P , .01 and P = .05, respectively) more frequently in the IPV group than in the control group. Conclusion:Intimate partner violence victims undergo more imaging studies and have a higher frequency of potential violencerelated imaging findings when compared with age-and sex-matched control subjects.

Addressing intimate partner violence during the COVID-19 pandemic and beyond: how radiologists can make a difference

“…Most IPV fractures affect the face (nasal bones, orbits, maxillofacial bones, and skull), followed by the fingers and upper trunk ( Fig. 1) [19][20][21][22][23]. Fig.…”

Making the ‘invisible’ visible: transforming the detection of intimate partner violence

“…High imaging utilisation has also been reported among the victims of IPV 10. For instance, a young patient with multiple facial CTs and upper extremity radiographs should alert the radiologist or provider to suspect recurrent violence.…”

“…Sadly, for adult victims, the situation is very different. The role that imaging could play to influence the detection of adult victims, similar to paediatric patients, has never been explored until recently 9 10. Radiologists are trained to simply report adult traumatic findings from the current examination without making any active effort to highlight any possibility of this life-threatening issue.…”

Incidence and characteristics of spinal injuries in the victims of intimate partner violence (IPV)

“…Although screening questionnaires have helped, the proportion of cases identified on the basis of self-reporting represents only the tip of the iceberg. The role of radiology in detecting IPV has only been recently explored [3,4]. Recognizing and documenting common and uncommon injury patterns linked to IPV on radiological studies can help identify victims early and thereby potentially saving lives.…”

“…Although common sites of IPV injuries include craniofacial structures, abdominal, genital areas, and extremities, a perpetrator could potentially avoid these known exposed sites and target the spine and back area, especially in the early stages of abuse or very late in the cycle of abuse [4]. The literature about the spinal injuries from IPV is anecdotal and limited to a few case reports [5] or as a small part of descriptive studies [6] assessing injuries in the IPV victims without attention to spine-specific findings.…”